How Sangyu Xi's New Dyson-Award-Winning Scoliosis Brace Grows With Its Wearer

Nicholas Hill  0:00  
You're listening to Acts of Impact, the show where we interview those who are making a positive difference in the world around us. I'm your host, Nicholas Hill, and today's guest is Sangyu Xi. Sangyu is an industrial designer who just received a National Dyson award for her design of an adjustable scoliosis brace named Airy. Airy is the first brace to grow with the patient, allowing teenagers to wear it more comfortably. We'll talk about scoliosis and the challenges of traditional braces, how Sangyu approach this from a design perspective, and ultimately the improvements that Airy provides. Let's get started.

Sangyu, welcome to the show.

Sangyu Xi  0:54  
Thank you. Thank you, Nicholas. Hi, everyone. My name is Sangyu. I'm very glad to be here talking about the project that I did, Airy scoliosis brace.

Nicholas Hill  1:03  
Yeah, absolutely. We're so glad to have you. Let's start by maybe just painting a picture for people that might not be as familiar with scoliosis. Can you just tell us kind of what that means for a patient and and how many people it affects?

Sangyu Xi  1:19  
Yeah, so scoliosis is a lateral curvature of the spine that occurs most often before the puberty. And there are about 7 million people in the US only that has this condition, and 80% of them are teenagers, girls usually have four times probability of getting it than boys. And if left untreated, it can lead to long satisfaction and a lifelong back pain and even surgery at the end.

Nicholas Hill  1:45  
I remember when I was in middle school and junior high in high school, they used to have us do like tests where they would they would like kind of run their hands on our back and they would check for for I think spinal curvature. Is that what they were looking for then?

Sangyu Xi  2:01  
Yeah, exactly. Actually, I discovered the problem of scoliosis brace because initially I was researching about that because you know, you know how uncomfortable and embarrassing the experience is right? Like the surgeon, kind of just touch your spines and touch around your body really just not the best settings for people to get that check. So when I was doing research for that, I discovered that scoliosis race is a even bigger problem like those. Those ones who got checked as scoliosis patients. There's like, bigger troubles that's waiting for them.

Nicholas Hill  2:37  
Let's talk a little bit more about the current ways that this is treated. If someone is diagnosed with scoliosis, how is that treated? Right now? They have a traditional brace that they wear do they wear it for a long period of time? How does that kind of work?

Sangyu Xi  2:53  
So yeah, all after a patient has been diagnosed with scoliosis he or she has to wear a brace for at least 18 hours a day. So that brace could be Boston brace, which is the most prevailing but also the research shows that there's only 18% of patients are actually wearing the brace for enough hours are other than others, so many other braces that has been developed like Charleston brace, it's a nighttime brace that you only need to wear during the nighttime. But therefore the efficiency isn't as good as Boston brace. And it's not designed for those ones who are, you know, over 40 degrees. Scoliosis versus only for those who are moderate curvature. That means if your your curvature is going over that 40 You just have to take a surgery no matter what. And you have to wear the brace until you finish your adolescence because at that point, you stopped growing and there is no possibility for your spine to get curve again. So that means if you get diagnosed on eight years old, then you probably have about like 10 years to weird scoliosis brace.

Nicholas Hill  4:00  
It sounds like there's a couple of different problems. So you have a traditional brace, where it could be very effective, but you're having to wear it for 18 hours a day. And we're finding that not a lot of people are doing that people are taking it off whenever it starts to get uncomfortable. Or maybe they just don't feel like wearing it because they don't like the way it looks. But then on the other side of that you have braces that you only have to wear at night, but then they're not as effective. And so you have this kind of trade off. Let's think about those current braces. What was it when you approached this challenge that you were really trying to solve for what were the main areas of traditional braces that you wanted to kind of fix or improve upon?

Sangyu Xi  4:46  
Yeah, I think there are several things I would say the first thing is about like bulky and hot like most of the design right now they are when you go to the hospital the doctor will take You have plaster mold or 3d scanning, by all means they try to take the silhouette or your of your body so that they can map the thermoplastic on to a model or yourself to make the silhouette that matches your body the most. And then they can make the brace and they can cut out the pieces that they don't want to make a brace for you. But for most times, in order to you know, keep the strength of the material they used to use a like a fifth five millimeter thick plastic that is very bulky. And with the inner feeling of the foam and all the other stuff like Velcro strap and there's some hardware over there, it can be very bulky for a teenager to wear at that point, they're still growing. So that means every two years they need to make a new one that's about the comfortability parts about it. The second part is it kind of limits they're leaving capabilities. I've heard a lot of people saying they sleep in a brace just feels like sleeping on the floor, or they couldn't even pick up the pencil or tie their shoes because the brace has limiting them from doing everyday things. And last thing I noticed is that all the things that I talked about before they reflect on one thing in the end is most of the patient have very low self esteem and big mental issue about themselves, or whether they're wearing the brace. The reason is that the brace has made them abnormal from their peers. And no matter it's the luck is how they act. Most makes them feel they don't want to wear the brace. And that has been making the adolescents even tougher for those who are having this condition.

Nicholas Hill  6:41  
So you have a patient's a lot of these patients are teenagers, they have issues with self esteem, where they're trying to figure out how they can wear this brace in a way that makes them feel confident. And they're just not really finding a lot of options. And so I know that you're approaching this as an industrial designer, I know for me, and probably some of my listeners were not as familiar with how an industrial designer approaches a problem like this. So could you tell us like, once you realize this was something that you wanted to work on? How do you get started? How do you start kind of mocking it up and working on it?

Sangyu Xi  7:23  
Yeah, absolutely. I mean, industrial design is really my superpower, I have been really ordinary kids growing up and others has defined my success for the first 18 years of my life until I met design. Because it's a really magic process. Like there are some problems that you feel like oh my god, this is so hard, it's impossible to solve. But as you progress, you find out there's a there's a process they can follow to actually make all the questions down to the essence and make it really easy to solve. So every time when we identify a problem in industrial design, I mean identify problem itself is arch, you have to go do a lot of research, the way that I do it, usually reading the thesis. I mean, scientific thesis from a lot of universities from National Science bases, those thesis are very detailed and they using they're they're based on a very large population, for example, they usually take about like over 100 user to do the experiments and eventually come out with a very meticulous conclusion. I think that's the best thing I can ever expect. And I could never be able to do this with myself with the limited budget. So usually when I find out, you know, there might be a problem, I go find all the pieces that has related to that. And then I extract the lesson that I from learn from there. And then I do a competitive analysis, try to see what other people have been practiced and proven to be good or bad. And then try to learn listen from there because you don't you don't want to start you know, reinventing the wheel in a project there is no enough time no enough budget for you to do that. And there's no necessarily for doing that. So after I identify that there's there's the problem with scoliosis brace, I look into other scoliosis brace. And then I take some lessons, some good things from the successful examples and take that into my ideation phase where I sketch about like 50 concepts, and they are all kind of different and try to figure out you know, which one I feel is the best read or you you just have a very vague impression about what is good, but that's okay. Then you have to go to you know, do some prototypes. When I was doing this project, I bought some plastic on Amazon plastic sheets, where you can use the heat gun to kind of just make them work and then I use those to make a very rough prototype of the concept I made and try to wear them and try to feel you know which one is the most comfortable, which one has the biggest potential and starting from there. I do More precise prototype, I went into CAD and tried to build this thing in CAD software like saw SolidWorks or Rhino and then print it out

Nicholas Hill  10:09  
And is that using like 3d printing techniques or using like an AutoCAD machine? How does that part work?

Sangyu Xi  10:16  
Yeah. So it is, you export the module that you made in the software, and then you can bring it to the 3d printer where you can print it out, and then get rid off the supports, and then try to you know, assemble them using screws and bolts, and then try to make the final products or working prototype for the, for the working products. That is a very, you know, very advanced technology nowadays that you can actually realize your concept in a very short time with very low budget.

Nicholas Hill  10:48  
That's great. And that sounds like something, it's an example of something we've talked about on the show before where advances in technology have allowed people to do really great things with smaller budgets than maybe they used to have. So I think that's really cool. And something else that you and I were talking about earlier is the compliance issue. So we talked a little bit about how they're supposed to be wearing at 18 hours a day, but not a lot of people are, how did you approach that part of the problem, you're creating these prototypes, but you also have to think about compliance. So what did you What did you do there?

Sangyu Xi  11:29  
Sure. So the the way that we do it is by integrating a worn time monitor in the back of the brace that has just begun to be pre building among all the brace design, because you really want to know if those patients are wearing them for enough hours when their parents is not around and watching them. There's also research shows that if a patient's persists to wear the brace for enough hours a day for the first six months, he or she is going to wear for enough hours, even in the rest of the treatment, even though nobody's watching them. So we were thinking about just integrate the monitor for the six months so that the patient don't need to deal with changing batteries and all the other technical issue that might happen later on. But idea is really you know, we have enough for the monitor where the patient and their parents can see how many hours have them been worn during the day. And it's split in the time that they were in a daytime and they were in the nighttime. The reason to do that is that during the nighttime, you probably have like five, seven to eight hours every day. And if you'd find out that you didn't wear enough hours for the day, for some weird reason, for example, you are a member in the swimming team, and you just couldn't wear the grace to swim, right. So then you find out that you don't really have enough hours for the day, then you can use the time in the night to implement that the hours that you lost in a day so that the patient can really allocate and design their days without sacrificing the efficiency of the treatment.

Nicholas Hill  13:01  
That's really cool. So it basically puts a little bit more power into the hands of the patient where they can say, hey, I want to wear this, I want to be compliant, but there are areas of my life where I can't. And so the app really allows them to kind of like you said, like supplement one area with another. And then on the other side of that you have parents who I'm sure are concerned and want to make sure that their child is wearing it for the right amount of time. And then the app also helps them to get that visibility, is that right? Exactly.

Sangyu Xi  13:35  
Uh, we don't want to be, you know, a watcher, a big brother of the patients and feel, make them feel stressful. Every time they look at our app, we want to be companion for them. This app is designed to help them not to kind of restrict them and you know, kind of be a supervisor of them. It's not that kind of relationship.

Nicholas Hill  13:52  
Yeah. And I know that that was a big part of a problem that you were looking to solve with some of the invasiveness and the privacy issues. Let's talk a little bit about airy. So where we left off in in your design story is that you were creating several prototypes. And ultimately, how do you decide or how did you decide on which one to move forward with? And then what are some of the big benefits that you were seeing in that prototype?

Sangyu Xi  14:21  
I think the key is to really defining your parameter of success like what do you how do you define if this is a successful product? To me, I think first thing is comfortability. I see that as the biggest problem of the current brace design. And I think the problem that I try to solve is the compliance issue so which mat whichever brace that gives me a feel that I want to wear it for longer hours and the others and which one makes me feel more comfortable light and you know, not restricting me from doing things then that's the design that I want to go into. So among all the designs, I pick the one that I can wear for the longest time and when I wear it, I don't feel the Feeling of invasive like some brace can make you feel really uncomfortable because they're ducking into your body. But someone's are really following your body shape and makes you feel like it's not there. And that's also why I named the brace airy because I want people to feel like they're wearing nothing. That's how I select this design among all the others.

Nicholas Hill  15:20  
One thing that that really stood out about Arie was that this is an adjustable brace. And you've talked to me a little bit about how a lot of these patients are teenagers, which means they're growing. And so how does the brace tackle that challenge when when you design your prototype, how did you make it to where it will kind of evolve with the patient?

Sangyu Xi  15:44  
Sure, so the the way that I solve this problem, because right now you have to go to the clinic every two years. So by the end of your treatment, you might have like four to six scoliosis brace because you're constantly growing, that's a big investment of money and energy and time. So what I do is to make the brace modular, so you have a back reel, and then you have four side pieces. So that way when you grow, you can regenerate the installation guide on our website, and we tell you exactly where each pieces should go on the back of the brace. So you can extend the brace at least 4.2 inches which accommodate three years of growth even at the teenagers fastest growing stage. And when I do the user research, one thing I found really interesting, I thought everyone is falling in love with the fashionable treats of airy, where it can change his color. And you know, it's it's much more good looking than the most embraces. But actually most patient choose the adjustability because the rest is hidden under your clothes, not so many people are going to see it. So they don't really care about how beautiful the braces they really care about if the brace is bulky and hard and make them uncomfortable. And the second thing most importantly, is they care how often they have to change a new brace. Because nobody wants to go through that painful and embarrassing process again, I guess.

Nicholas Hill  17:06  
Yeah, that makes sense. So you so you're doing some some focus testing, you're finding that people are really leaning into the adjustability of it. One of the other issues that you were talking about at the beginning, is whenever you get a traditional brace put on that something that you typically have to go to a physician and they're having to kind of be very hands on with how they do that. Does Arie solve for that in any way? Or how does Eric kind of tackle that that problem?

Sangyu Xi  17:38  
Yeah, I think that's the another thing that everybody loves about airy is how it can be set up at home by yourself. So I was inspired by Invisalign because my friend was having an Invisalign at that point, when I was designing airy. And I find out you know, why don't we just have the patient to input their body and scoliosis information so that way we can generate a installation guide. First, we can pick a right size for them without them to try several ones. And then we can generate a installation guide that points out which which location that each piece is should be going so that way the patient can receive the products with the installation guide and actually set up the price by themselves with their loved ones. So they don't feel their privacy has been invaded, and things become much easier. They don't wait. They don't need to wait for that four weeks manufacturing time traditionally happening with current races. They really just need to wait for one week where we ship this off the shelf products with a installation guide that's tailor made for them.

Nicholas Hill  18:40  
One of the other areas that I really really loved about Eri was that it is recyclable in a lot of different ways. There there's a sustainability around airy. Can you tell me what is the difference between someone who's finished with a traditional brace and what they what their options are? Versus someone who's finished with airy and what their options are.

Sangyu Xi  19:07  
So yes, that's one another big reason why so many people laughs airy through all the research everybody has chosen that one as one of their top three favorite treats. So currently with the scoliosis brace for his for example, the Boston brace, it has plastic on the outside and then foam that has been glued on to the plastic and then in the front there is real Chrome that has been fixed on it was a hardware and there's so many things just so many materials, so many materials in color. So different materials that you can only dump this into landfill after you finish because no one else can fit into your your race. Everybody's scoliosis and everybody's body is kind of different is going to cost you a lot of time and energy trying to find someone who can actually buy your brace. So right now they are dumping to the landfill but um That's a lot of waste of, you know, material and also a big burden for the environment to consume. So when I was designing airy, I carried that always in the back of my mind, in airy, there is no synthetic glue that has been used. So you can recycle all the reagent parts up to 10 times. And you can also choose to trade in the brace for a discount on your next brace. If you are still growing and you haven't finished your treatment yet, or you can choose to donate the brace to the third row, here's where the scoliosis brace appears to be even harder to be accessible. So these are the options that I provide for any customers that's registered in our website. And I think that's just a very important part is to design new products, you have to think about its afterlife, because everything that you get, or the fortune that you get from this product is borrowed from the environment.

Nicholas Hill  20:51  
Yeah, I think that's such a huge advantage. Because we talked earlier you said there are millions of people that are affected by scoliosis. And when I think about millions of braces that are being dumped in the landfill, or just not able to be reused, that adds up. And so I think that when I heard that about Eri, I thought that that really stood out to me, having that sustainable aspect of it is great. What have you heard from those who have actually tried out Arey. Have you started kind of focus testing? And how has the feedback been so far?

Sangyu Xi  21:31  
Yeah, so I've tried, I've did like two runs or validation tests in Cincinnati Children's Hospital, where I was able to fit a brace onto five patients, it's a relatively smaller sample, because due to the time and budget I have at that point. So four out of five patients had a really strongly positive feedback to me that they sang. If they have ever had the option to change their brace, they will choose area over their current braces. And if the next time I ask them for credit card information, that's someone who from pre accelerator program taught me if you really want to test if somebody loves your products, ask them for their credit card information. And the result is yes, four out of five was really happy about it. But there are several things like engineering problem was the brace right now they're they're making it couldn't reach the pressure. That's the traditional prices can be mainly about the strength of the material, because I print the brace out of our 3d printers. So compared to the thermoplastic, that has never been breakdown, it's much less stress. And also, because of the front closure, I would say there's still a long way to go for every, at least until next year's March, we couldn't see any working prototype that could be put into clinical experiments.

Nicholas Hill  22:54  
Got it. And I want to dive in just a little bit further to that. So what is next for airy? So now, you know, you've received this national award from Dyson, is there a second round to that? What is the next step to getting this into a clinical trial?

Sangyu Xi  23:10  
Yeah, so for Dyson award, there are one national winner for each country and then the engineers at James Dyson Foundation, they will select top 20 works and be submitted to Sir James Dyson for him to review. So after he reveal, he will select one international winner who can win about like $40,000 I think and then on another sustainable we know who when the same amount that can help them with their further development. So areas right now under that process, competing with other entries to fight for the international or international sustainable winner. And I have the plan for airy is first we have to prove that a reaches all the technical parameter that traditional braces can so that we can convince the doctors that you can actually put this onto a real patients and it's not a waste of their time to kind of you know fit into this product. And we also need founding which will provide the product for the patients with a really low cost, where they were we might give also give them some stipend for awards, rewarding their willingness to join the experiment on there should also be you know, some peer review that's going to review the documentation now we submit to prove that airy actually works and then we have to go through the FDA approval two years later. Then when we got the FDA approval I really hope that Eric could be acquired by a big company because scoliosis brace is a very is a relatively smaller market and other prosthetics because not all the scoliosis patients acquire a scoliosis. Right. And it's not a product that can follow them for the rest of their life. So I really wish that somebody who has better resource and have, you know, a bigger team can actually take over Arey, at that point and actually make it a product that everybody could use.

Nicholas Hill  25:16  
When you first started kind of testing area out and talking to the patients that were able to wear it. I mean, how did that feel? I'm sure it feels good to be able to see someone actually using something that you've designed and and see that come to fruition? I mean, what is what is that like?

Sangyu Xi  25:39  
I mean, the first time that I take it to the clinic, I was terrified, because I am so worried that the patient can can you know, really hate it. But after one in the first two patients have said they really liked it, I feel like really, really overjoyed to learn that because, you know, everything that I sacrifice has paid off. And I feel like there's nothing better than the feeling that you know that you are you're doing something that's effecting positive change to the world. You know, this kind of thing doesn't happen every day. Some people they have a lot of powers, they have a lot of fortune, but they don't do the same thing as you do. Because they, they're they're very satisfied with where they are right now. But I think people like me, who are really wishing that the world could be a better place for many other underprivileged, we really want to see that our act could inspire and encourage more and more people in the future to do the same act. I mean, just look at airy, like ever since he has won a national winner. There's so many awareness that has been raised among those scoliosis patients, family and friends to care really care about their physical and mental well being. Whereas before, they might be always ignored because people are treating them as you know, survivors, and they don't feel like how they really feels about it. They don't ask if you are really happy about your scoliosis race, if you're really happy about, you know, all the treatments, they just think that's what they need to go through. But as designer, I'm telling everyone, that's not necessarily the only solution that we have. There should be more designers and engineers that can be inspired to solve some problem that we see in the world, not just technically but also from an emotional standpoint, because I think good designs are the ones that last a long time and people can still see the patina of humanity in her work.

Nicholas Hill  27:33  
I think that's incredible. I really, really appreciate you taking the time to talk with me today song you and and I'm just really excited to see what comes of airy and I wish you the best of luck with airy and hope to see more from it in the future. And thank you so much.

Sangyu Xi  27:50  
Yeah, thank you so much. Happy to talk to you today too.

Nicholas Hill  28:07  
Today's show was directed and produced by me with music from Alex scroll. Special thanks to our guests for their time and insight. If you like today's episode, please follow us wherever you listen to podcasts, and consider leaving a review as it will help us to spread the word about the show. You can view more information about today's episode online at acts of impact.com Thank you for listening